168 BOVINE 0BSTETBIC3 



After the incision has been made the operator enters with 

 the carefully cleansed arm into the abdominal cavity, acquaints 

 himself with the direction of the torsion and whether ruptures 

 are present or not. This examination must be made exceed- 

 ingly carefully, to avoid being accused of producing injuries 

 already existing. 



In right torsion the right hand of the operator penetrates 

 between the uterus and lower right abdominal wall and attempts 

 to reach beneath the uterus the linea alba, or, if possible, the 

 left side of the uterus. When successful he grasps there a leg 

 of the calf and the uterus, pulling it gradually in his direction, 

 at the same time raising the uterus. These manipulations are 

 materially aided when an assistant at the same time presses 

 against the left lower abdominal region, or when the belly is 

 raised by means of a board (Franck). lu left torsion, the hand 

 is allowed to glide over the upper face of the uterus to the left 

 side as deeply as possible ; there parts of the calf and uterus 

 are secured and thrown toward the operator. 



A well instructed assistant, whose hand is in the vagina 

 during the operation, can feel immediately when retroversion is 

 successful, as his hand can then pass by the spiral folds. He 

 may also assist in further retroversion. 



Retroversion from within the abdominal cavity is a hercu- 

 lean task, and it is not always possible to twist a weight of 

 occasionally 70 to 80 kg. with one hand ; at the same time as 

 much as possible of the uterus and calf must be raised in order 

 to I'ull on it carefully (Franck). 



Prognosis. — When the operation takes place on the second 

 day and the genital passages have not been injured by rough or 

 unskilled aid, this method may be successful ; but when the 

 owner waits three or four days and symptoms of peritonitis are 

 noticeable, prognosis is exceedingly unfavorable, especially 

 when after laparotomy a greatly distended uterus from an 

 emphysematous foetus is revealed. Such cases are fatal. 



Eetroversion after laparotomy is a very good method and 

 successful in many instances when the operation and reduction 

 occur in time and no disturbances exist from previously applied 



